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1013054485
STACIE GRANT
LOCKPORT, NY
NPI
1013054485
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LW0102X Nurse Practitioner, Women's Health
(Licence: NY 420749)
Enumeration Date
2007-02-01
Last Update Date
2009-03-13
Business Address
-- STACIE GRANT N.P.
38 HERITAGE CT
LOCKPORT, NY 14094-3616
Phone number: 716-433-4465
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Mailing Address
-- STACIE GRANT N.P.
100 PARKRIDGE AVE
BUFFALO, NY 14215-2210
Phone number: 716-433-4465
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